title: Rural residence and cancer outcomes in the United States: issues and challenges.
abstract: "Neighborhoods and health" research has shown that area social factors are associated with the health outcomes that patients with cancer experience across the cancer control continuum. To date, most of this research has been focused on the attributes of urban areas that are associated with residents' poor cancer outcomes with less focused on attributes of rural areas that may be associated with the same. Perhaps because there is not yet a consensus in the United States regarding how to define "rural," there is not yet an accepted analytic convention for studying issues of how patients' cancer outcomes may vary according to "rural" as a contextual attribute. The research that exists reports disparate findings and generally treats rural residence as a patient attribute rather than a contextual factor, making it difficult to understand what factors (e.g., unmeasured individual poverty, area social deprivation, area health care scarcity) may be mediating the poor outcomes associated with rural (or non-rural) residence. Here, we review literature regarding the potential importance of rural residence on cancer patients' outcomes in the United States with an eye towards identifying research conventions (i.e., spatial and analytic) that may be useful for future research in this important area.
authors.affiliation: Authors' Affiliations: Departments of Health Care Policy and Medicine, Harvard Medical School, Department of Society, Human Development, and Health, Harvard School of Public Health, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; and Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, Division of Epidemiology, College of Public Health, and Division of Cancer Control and Prevention, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio.
authors.forename: Ashley
authors.initials: A
authors.lastname: Meilleur
authors.forename: S V
authors.initials: SV
authors.lastname: Subramanian
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Plascak
authors.forename: James L
authors.initials: JL
authors.lastname: Fisher
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Lamont
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D012424:Rural Population / Q000706:statistics & numerical data*; D012931:Social Environment; D014481:United States / Q000453:epidemiology